What is Kienbocks?

Answer 1

Kienböck's Disease
Bone is living tissue that requires a regular supply of blood for nourishment. If the blood supply to a bone stops, the bone can die, a condition known as osteonecrosis. That's what happens in Kienböck's disease, which affects the lunate, one of the small bones of the hand near the wrist

Answer 2

Kienbock's disease, properly spelled Kienböck's, is also known as Avascular Necrosis of the Lunate, or Lunatomalacia. It was first described by Viennese radiologist Dr. Robert Kienbock in 1910.

It is a painful condition and, while not life-threatening, it is life-altering. It can force changes in lifestyle, hobbies, even professions, especially during treatment and possibly after treatment, even if the treatment is deemed "successful."

Through some traumatic event or series of events, the lunate -a bone in the wrist- is injured in such a way that the blood supply to the bone is cut off and the bone begins to die.

Only the lunate bone dies, and the condition does not "spread" to other bones or parts of the body.

As the bone dies, pain is generally reported. There may be a period of lesser pain afterward that may last for quite some time, maybe a few days or possibly even years, during which there are no substantial changes to the wrist structure.

Left undiagnosed or untreated, the lunate eventually flattens and collapses and may break into several pieces (fragment). These pieces can shift (displacement) causing pain and/or swelling. For some this is periodic or sporadic, for others it is excruciating and constant, or it can be anything in between.

As the lunate collapses, the other wrist bones (carpals) may migrate. This also causes discomfort in some and pain in others.

The motion of the wrist becomes restricted. It becomes impossible to bend the wrist completely forward (flexion) or backwards (extension). It is not something that can or should be forced; it simply will not go.

Strength is also gradually lost in the hand.

In the latter stages, generalized arthritis sets in.

As this is a Rare Disease, little is known about its cause or treatment.

It is believed that a difference in the lengths of the arm bones (the radius and ulna), known as Ulnar Variation --generally this is a negative ulnar variance, which means the ulna is shorter than the radius by a few millimeters-- is a predisposing factor. Because the bones are asymmetrical, greater "load" or stress is put on the lunate making it more susceptible to this condition. Especially in people with ulnar variance, it is possible to have this condition in both wrists (bilaterally).

A second predisposing factor would be a variation in the blood supply to the lunate itself. Normally there are multiple vessels supplying blood to the lunate, and an injury to one of them would be inconsequential, but some people were born with only one vessel to the lunate. An injury to that vessel could lead to Avascular Necrosis, which is to say, Kienbock's Disease.

Other possible causes are frequent, repetitive strains or a single trauma to the lunate such as a fracture, or abnormalities of the blood's clotting process (hypercoagulability or hypofibrinolysis).

A person is usually diagnosed when he has been in some pain for a while and has a doctor x-ray the wrist. Other times there may be a more-or-less sudden burst of pain that sends him to the doctor.

While an x-ray is adequate for diagnosing and staging the condition, an MRI is often ordered for a more complete look at the joint.

Every case of KD is different. No two joints will progress in exactly the same way or on the same schedule, but there are significant commonalities.

It is not contagious in any way.

Possibly the single most important thing that can be said to a person who is suffering from this condition is that it will get better. You will not have to live the rest of your days at this level of pain. Treatments are available.

If you or a loved one has been diagnosed with Kienbock's, I strongly urge you to join the Yahoo! support group owned by Angela Byers. It is an invaluable source for information and support with candid discussions among KD sufferers. The list may be sent to your inbox as individual posts or in a digest form, or you can read it from the website.

Answer 3

It is a problem where blood supply to one or more of the bones in the wrist is interrupted and the bone dies. There is some pain and you need to see an orthopedic surgeon about getting that fixed. There are many ways to keep the wrist functioning properly.